时间-空间相关成像M型技术联合组织多普勒成像技术评价三尖瓣反流胎儿右心功能

Application of spatio-temporal image correlation M-mode together with tissue Doppler imaging in evaluation of right ventricular function of the fetus with tricuspid regurgitation

目的:探讨时间-空间相关成像(Spatiotemporal image correlation,STIC)-M型技术联合组织多普勒成像(tissue Doppler imaging,TDI)技术评价单纯三尖瓣反流胎儿右心功能的价值。方法:选取孕20～41+6周孕妇243例(除外心内及心外畸形),其中三尖瓣反流胎儿83例,依照反流程度不同分为:轻度反流组(63例)、中度反流组(20例),160例无三尖瓣反流胎儿为对照组。应用STIC-M型技术测量各组胎儿三尖瓣环位移(tricuspid annular displacement,TAD),并用TDI技术测量各组胎儿三尖瓣环舒张早期运动速度(E')、舒张晚期运动速度(A')、并计算E'/A'值,比较各组参数。结果:轻度反流组胎儿TAD、E'、A'、E'/A'值与对照组比较,差异均无统计学意义(P>0.05),中度反流组胎儿TAD、E'、A'、E'/A'值均低于对照组及轻度反流组,差异均有统计学意义(P<0.05)。结论:应用STIC-M型技术联合TDI技术能够评价准确评价三尖瓣反流胎儿右心收缩及舒张功能的变化情况,为指导临床积极治疗及适当时机分娩提供重要依据。

Objective:To explore the application value of spatio-temporal image correlation M-mode (STIC-M)together with tissue Doppler imaging (TDI)in evaluation of right ventricular function of the fetus with tricuspid regurgitation.Methods: 243 fetuses from 20to 41^+6weeks were divided into 3 groups,160 fetuses without tricuspid regurgitation as the control group,63 fetuses with mild tricuspid regurgitation as the mild regurgitation group,20 fetuses with moderate tricuspid regurgitation as the moderate regurgitation group.STIC-M was used to measure the tricuspid annular displacement (TAD).TDI was used to measure early and late diastolic tricuspid annular velocity (E′ and A′),as well as E′/A′.Statistical analysis was performed to compare these parameters.Results:There were no significant differences in TAD,E′,A′ and E′/A′ between the mild regurgitation group and the control group (P>0.05).The TAD,E′,A′,and E′/A′ of the moderate regurgitation group were significantly lower than those of the control group and the mild regurgitation group (P<0.05).Conclusion:STIC-M combined with TDI can accurately evaluate right ventricular systolic and diastolic function of the fetuses with tricuspid regurgitation, which can provide important information in guiding the active clinical treatment and choosing the appropriate delivery opportunity.